Receipt form or blank.



110,768,338. PATBNT'ED AUG.23,1904.

E.K. NADEL.

RECEIPT FORM OR BLANK.

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Patented August 23, 1904.

PATENT FFICE,

i EnwiN K. NADEL, or ELKHARnTNDrANA.

RECEIPT FORM 0R BLANK.

SPECIFICATION forming part of Letters Patent No. 768,338, dated August 23, 1904. Application filed October 30,1908. Serial No. 179,196. (No model.)

To a/ZZ whom t may con/cern.

an improved receipt form or blank for use in' receipting payments by instalments upon running accounts, so that the amount of matter to be entered on the receipt-blank .to show each debit is reduced to a minimum, the total amount paid at any time shown by the receipt without the necessity of calculation, and the necessity of keeping other `records of the transaction entirely obviated.

In attaining the object above stated I make use of the novel receipt form or blank hereinafter described, illustratedin the accompanying drawing, and particularly specified in the appended claim. l

-In the drawing there is shown a receiptform upon which several entries have been made, but the account has not been closed.

Y Referring to the drawing, 1 designates the heading, which will preferably include at the top'the name of the establishment issuing the receipt and will also include a statement of acknowledgment of the sums entered upon thereceipt. The heading mayV also include'a space for entering the route of the collector who receives the sums entered upon the receipt, as shown at 2. Below the heading there will preferably be placed on the receipt a sentence advising thev retention of the receipt until computed, when another will be issued. A warning sentence is shown in the form illustrated at 3. At the other end of the receipt-blank is provided a heading arranged to be read with the receipt in inverse position. This heading 4: comprises blank spaces for the entry of the-name and address of the person to whom the receipt is issued, as well as a blank for entering any other data which it is desired that the receipt shall show. v

Between the headings l and 4 the receipt is divided transversely into a series of spaces 5, each of which is designed for theentry of4 a single debit, and in order that the receipt may be easily4 divided to. separate the lled spaces from the unfilled spaces transverse lines 6 are provided between the several spaces. Each of the spaces 5 has in the left end, as seen in the drawing, a statement of the amount to be paid' at each instalment, and vatthe opposite end is a statement of the total amount that will have become due after that space and the preceding spaces havebeen filled by entries. The intermediate'portion of each space is left blank for the insertion -therein of the-date of a debit,

Erom the foregoing description/it will. bev seen that in order to record a singledebitin proper form upon the receipt it is only niec-y essary to enter in ,the blank portion of the first space the date of the debit, and if the receipt is then torn upon the transverse line just below that spacethe total amount paid will be indicated by the matter in the right end of that space. Similarlywhen several debits have been' made the dates thereof will ali be shown by the entries in several of the spaces, andthe total paid will be shown by the matter at the right end of' the space last filled. e

It is intended that whenever a payment is made before a receipt form or blank is completely filled Ythe receipt-form will be torn across immediately 'below the entry of the last debit, and the person making the payment will retain the upper portion of the receipt, while the lower portion will be returned to the establishment issuing it. In order that the portion of the receipt returned to the issuing establishment may show at a glance and without calculation how :much has been paid, small figures in inverted position are placed in all of the spaces 5 but the first one and also immediately below the last space, these figures corresponding in each case` to the figures in the space just preceding. When, therefore, the receipt-form is tornV across on any one of the lines of division, the small figures in the space adjoining the line of tearing will indicate the amount ofthe payment, as

shown in the last space on the portion of the receipt-form retained by the person making the payment.

In the receipt form illustrated the payments are assumed to be made weekly, as is usually the case in paying subscriptions for newspapers received from carriers; .but it is to be understood that the payments need not be made by the week or, indeed, at any detinite intervals. It' the payments are to be made monthly, the matter in the left end of each of the spaces 5 will be changed accordingly, and if the payments are not to be made at regular intervals, but each payment is to be of different size, the amount only of each payment will be printed in the left end or' each oi' the spaces 5.

From the foregoing description and the drawing it will be easily seenthat the improved receipt-iorm affords means for keeping accounts of small payments at intervals with a minimum or' labor in entering the several payments, and whenever the sum due has been paid the receipt may be torn in two, one part being kept by the person making the payments and the other by the payee, and both sections of the receipt will show exactly the amount paid.

The stubs of the receipts returned to the payee when the payments cease may be iiled and form a permanent record of all the transactions entered on the portion of the receipt retained by the person making the payments, the necessity of separate entries in recordbooks being thus completely obviated.

Having thus described the construction and use of my invention, what .l claim as new, and desire to secure by Letters Patent, is-

A receipt form or blank provided at opposite ends with oppositely-disposcd headings of suitable character and having the spaces between said headings divided by transverselydisposed lines into a plurality of spaces, cach of said transversely-disposed spaces having a yportion left blank and having in one end matter indicative of the amount of a single instalment and having in the other end matter indicative of the total amount paid including the instalment indicated in that division oi the receipt, said receipt being also provided with ligures arranged in all but the lirst oi said spaces and immediately below the last space to indicate the totals paid including the instalments indicated in the spaces below which said figures appear, said ligures being reversely disposed with reference to the other gures upon the receipt form or blank, in order that when the receipt is computed and the computed portion separated from the uncomputed, the portion of the receipt form or blank which is retained by the issuer thereof will show the total amount received thereon.

In testimony that l claim the foregoing as my own I have hereto aiiixed my signature in the presence of two witnesses.

ERWIN K. NADEL.

Witnesses:

A. P. KENT, FRANK G. STAHR. 

